Washington and You

A July 29 report by the Institute of Medicine on reforming the nation’s graduate medical education program has struck a nerve with the AUA and other medical societies by questioning the seriousness of continuing physician shortages in the United States.

Important developments that could have an impact on urology practices include an attempt by the Centers for Medicare & Medicaid Services to provide more flexibility for providers in how they use certified EHR technology to meet meaningful use requirements and be eligible for program payments as well as proposed revisions to the FDA's “Guidance for Industry: Distributing Scientific and Medical Publications on Unapproved New Uses—Recommended Practices.”

Two years ago in May, the U.S. Preventive Services Task Force recommended against PSA-based screening for prostate cancer, asserting that “many men are harmed as a result of prostate cancer screening and few, if any, benefit.”

The law signed April 1 that avoided the slated 24% Medicare physician payment cut for this year will intensify federal scrutiny of the current system for valuing specific medical services, a procedure that is at the heart of how much doctors get paid.

The latest SGR patch includes a provision that instructs Medicare officials to review the value of some procedures and sets a target for reductions of misvalued codes, which has drawn the criticism of organized urology.

New AUA Director of Government Relations and Advocacy Brad Stine intends to advocate for the AUA’s SGR policy: to gain affirmative repeal of the formula that has proven so troublesome over the years for urologists, whose patient population includes a large percentage of Medicare enrollees.

Congress may be ready to trade in the SGR for a VBP and an APM to fix the difficult physician fee schedule situation that has plagued urologists and other Medicare physicians for a decade. But while the AUA wants the SGR to go away, the organization has significant reservations about this latest plan.

It appears that Congress is finally determined to provide a permanent solution to the annual Medicare fee payment crisis, and there is a possibility that the process also could reduce pressure to end an exception to the Stark self-referral law upon which many urologists have come to rely.